Médecine pulmonaire et respiratoire

Management of Pulmonary Interstitial Emphysema in a Premature Infant using Nasopharyngeal High-Frequency Oscillatory Ventilation

Abstract

Khalil I. Al Tawil, Ibrahim A. Ahmed, Hesham Tawakol, Noura Bin Saleem, Saif A. AlSaif and Alaa Eldemerdash

Pulmonary interstitial emphysema in mechanically ventilated premature infants is a serious complication that is difficult to manage and is associated with a poor prognosis [1]. We describe a premature infant with respiratory insufficiency secondary to severe pulmonary interstitial emphysema that was managed with nasopharyngeal highfrequency oscillatory ventilation, as a non-invasive mode of ventilation. Our case report does not clearly differentiate whether the improvement in gas exchange and eventual resolution of PIE are attributable to the use of non-invasive HFOV or to the use more appropriate low frequency (7Hz) with the non-invasive approach. Further studies of NP-HFOV use in infants with PIE are needed to support our report Conclusion: NP-HFOV may be utilized in infants with PIE associated with compromised respiratory function. NPHFOV may decrease the chance of further pulmonary complications, including pneumonia and lung atelectasis, and facilitate care of sick infants while on NP-HFOV.